On September 27, 2019, the U.S. Department of Justice issued a press release summarizing multiple healthcare fraud cases recently filed nationwide. The targets of the government's cases involve telemedicine companies, cancer genetic testing laboratories, and over 170 medical professionals, including doctors. The federal indictments were filed in U.S. District Courts in Florida, Georgia, Louisiana, New Jersey, and Texas.
If any medical professional, including doctors, physician's assistants, nurses, and pharmacists, are convicted, they can suffer long prison sentences and lose their professional licenses.
While efforts to control fraud and abuse in healthcare must continue, government investigators and prosecutors can and do make mistakes or take overly aggressive positions when reviewing evidence. These oversights can result in innocent defendants being wrongfully convicted.
In recent cases, allegations of healthcare fraud describe doctors receiving kickbacks for prescribing genetic tests from a particular laboratory.
Unnecessary Procedures and Insurance Interference
If the government theorizes that tests, treatments, or procedures are not medically necessary, they will seek to criminalize a doctor for prescribing them. A doctor’s diagnosis and treatment of a patient is deemed to be fraudulent if a government investigator or attorney decides that the doctor’s treatment was not medically necessary. Such decisions often rest upon the testimony of other doctors hired by insurance companies who then report their findings to the government investigators.
Doctors may be reluctant to prescribe a medical procedure if they are subject to second-guessing by insurance company clerks who contend that a procedure, medical test or drug is medically unnecessary. Such decisions, on the part of insurance companies and doctors hired by insurance companies, are in many instances designed to cut costs and increase profits. Unfortunately, federal investigators, whether they be from the FBI, DOJ or the U.S. Department of Health and Human Services Office of the Inspector General, can be influenced by the opinions of insurance companies and other entities that pay for healthcare and prescription medications.
The indictment of any medical professional will have adverse effects upon their livelihood.
Any member of the healthcare industry who learns of an investigation by the government or an insurance company should act quickly to retain experienced white-collar criminal defense counsel.
By obtaining an attorney early in the investigation, a healthcare professional may avoid an indictment. Our attorneys will do everything in our power to convince the government that its investigation is flawed.
There are times, however, when even if the government is wrong, their position is so entrenched that an indictment is inevitable. In those situations, early representation by an experienced defense attorney enhances the likelihood of a successful outcome at trial through proactive defense investigation and preparation.
The Law Offices of Horwitz & Citro P.A. have successfully defended healthcare professionals by convincing the government that its investigation is flawed and that a client should not be indicted. We stand as the shield to protect our clients’ liberty.
Call us at (407) 901-5852 and schedule your consultation today.